Neck Problems and Injuries

Topic Overview

Most people will have a minor
neck problem at one time or another. Our body movements usually do not cause
problems, but it's not surprising that symptoms develop from everyday wear and
tear, overuse, or injury. Neck problems and injuries most commonly occur during
sports or recreational activities, work-related tasks, or projects around the
home.

Neck pain may feel like a "kink," stiffness, or severe pain.
Pain may spread to the shoulders, upper back, or arms, or it may cause a
headache. Neck movement may be limited, usually more to one side than the
other. Neck pain refers to pain anywhere from the area at the base of the skull
into the shoulders. The neck includes:

The
discs that separate the cervical vertebrae and absorb
shock as you move.

The muscles and
ligaments in the neck that hold the cervical spine
together.

Neck pain may be caused by an injury to one or more of these
areas, or it may have another cause. Home treatment will often help relieve
neck pain caused by minor injuries.

Activities that may cause neck pain

Neck pain is
often caused by a strain or spasm of the neck muscles or inflammation of the
neck joints. Examples of common activities that may cause this type of minor
injury include:

Holding your head in a forward posture or odd
position while working, watching TV, or reading.

Sleeping on a
pillow that is too high or too flat or that doesn't support your head, or sleeping on
your stomach with your neck twisted or bent.

Spending long periods
of time resting your forehead on your upright fist or arm ("thinker's
pose").

Stress. Tension may make the muscles that run from the back
of the head across the back of the shoulder (trapezius muscle) feel tight and
painful.

Work or exercise that uses your upper body and
arms.

Sudden (acute) injuries

Minor neck injuries may
result from tripping, falling a short distance, or excessive twisting of the
spine. Severe neck injuries may result from whiplash in a car accident, falls
from significant heights, direct blows to the back or the top of the head,
sports-related injuries, a penetrating injury such as a stab wound, or external
pressure applied to the neck, such as
strangulation.

Pain from an injury may be
sudden and severe. Bruising and swelling may develop soon after the injury.
Acute injuries include:

An injury to the ligaments or muscles in the
neck, such as a
sprain or
strain. When neck pain is caused by muscle strain, you
may have aches and stiffness that spread to your upper arm, shoulder, or upper
back. Shooting pain that spreads down the arm into the hand and fingers can be
a symptom of a pinched nerve (nerve root compression). Shooting pain is more
serious if it occurs in both arms or both hands rather than just one arm or one
hand.

A fracture or dislocation of the spine. This can cause a
spinal cord injury that may lead to permanent paralysis. It is important to
use correct first aid to immobilize and transport the injured person correctly to reduce the risk of
permanent paralysis.

A torn or
ruptured disc. If the tear is large enough, the jellylike material inside the
disc may leak out (herniate) and press against a nerve or the spinal cord
(central disc herniation). You may have a headache, feel dizzy or sick to your
stomach, or have pain in your shoulder or down your arm.

Emergency care is required for a neck injury that causes
damage to the spinal cord. Symptoms of a spinal cord injury include loss of
movement or feeling, numbness, tingling, difficulty controlling the muscles of
the arms or legs, and loss of bowel or bladder control.

Conditions that may cause neck problems

Neck problems
may not be related to an injury.

Arthritis or
damage to the discs of the neck can cause a pinched nerve. Neck pain caused by
a pinched nerve generally affects one side of the neck and the arm on that
side. Other symptoms may develop, such as numbness, tingling, or weakness in
the arm or hand.

Meningitis is a serious viral or
bacterial illness that causes inflammation around the tissues of the brain and
spinal cord. Symptoms come on quickly and include severe headache, stiff neck,
fever, and sometimes vomiting. The neck stiffness makes it hard or impossible
to touch the chin to the chest.

The
flu, which usually is not serious, can cause symptoms
similar to meningitis. When neck pain is caused by flu, the neck and the rest
of the body tend to ache all over, but severe neck stiffness is
absent.

Neck pain that occurs with chest pain may be caused by a
serious problem with the heart, such as a
heart attack.

Stress and tension may make
the muscles that run from the back of the head across the back of the shoulder
(trapezius muscle) feel tight and painful. You may not be able to move your
head without pain.

Torticollis is caused by severe muscle
contraction on one side of the neck, causing the head to be tilted to one side.
The chin is usually rotated toward the opposite side of the neck. Torticollis
may be present at birth (congenital) or caused by injury or disease.

Treatment

Treatment for a neck problem or injury may
include first aid measures, physical therapy, manipulative therapy (such as
chiropractic or osteopathic), medicine, and in some cases surgery. Treatment
depends on:

Severe pain (8 to 10): The pain
is so bad that you can't stand it for more than a few hours, can't sleep, and
can't do anything else except focus on the pain.

Moderate pain (5 to 7): The pain is bad enough to disrupt your
normal activities and your sleep, but you can tolerate it for hours or days.
Moderate can also mean pain that comes and goes even if it's severe when it's
there.

Mild pain (1 to 4): You notice the pain,
but it is not bad enough to disrupt your sleep or activities.

Make an Appointment

Based on your answers, the problem may not improve without medical
care.

Make an appointment to see your doctor in the
next 1 to 2 weeks.

If appropriate, try home treatment while you
are waiting for the appointment.

If symptoms get worse or you have
any concerns, call your doctor. You may need care sooner.

Call 911 Now

After you call
911 , the operator may tell you to chew 1 adult-strength (325 mg) or 2
to 4 low-dose (81 mg) aspirin. Wait for an ambulance. Do not try to drive yourself.

Symptoms of serious illness may
include:

A severe headache.

A stiff
neck.

Mental changes, such as feeling confused or much less
alert.

Extreme fatigue (to the point where it's hard for you to
function).

Shaking chills.

Seek Care Now

Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

Call your doctor now to discuss the symptoms and
arrange for care.

If you cannot reach your doctor or you don't have
one, seek care in the next hour.

You do not need to call an
ambulance unless:

You cannot travel safely either by driving
yourself or by having someone else drive you.

You are in an area
where heavy traffic or other problems may slow you down.

Major trauma is any event that can
cause very serious injury, such as:

A fall from more than
10 ft (3.1 m) [more than
5 ft (1.5 m) for children under
2 years and adults over 65].

A car crash in which any vehicle
involved was going more than
20 miles (32 km) per
hour.

Any event that causes severe bleeding that you cannot
control.

Any event forceful enough to badly break a large bone (like an arm bone or leg bone).

Postoperative Problems

Call 911 Now

Based on your answers, you need
emergency care.

Call911or other emergency services now.

Do not move the person unless there is an immediate threat to the person's life, such as
a fire. If you have to move the person, keep the head and neck supported and in
a straight line at all times. If the person has had a diving accident and is
still in the water, float the person face up in the water.

Severe trouble breathing means:

The child cannot eat or talk because he or she is
breathing so hard.

The child's nostrils are flaring and the belly
is moving in and out with every breath.

The child seems to be
tiring out.

The child seems very sleepy or confused.

Moderate trouble breathing means:

The child is breathing a lot faster than
usual.

The child has to take breaks from eating or talking to
breathe.

The nostrils flare or the belly moves in and out at times
when the child breathes.

Mild trouble breathing means:

The child is breathing a little faster than usual.

The child seems a little out of breath but can still eat or talk.

Severe trouble breathing means:

You cannot talk at all.

You have to
work very hard to breathe.

You feel like you can't get enough
air.

You do not feel alert or cannot think clearly.

Moderate trouble breathing means:

It's hard to talk in full
sentences.

It's hard to breathe with activity.

Mild trouble breathing means:

You feel a little out of breath but can still talk.

It's becoming hard to breathe with activity.

Symptoms of difficulty breathing can range from mild to severe. For example:

You may feel a little out of breath but still be able to talk (mild difficulty breathing), or you may be so out of breath that you cannot talk at all (severe difficulty breathing).

It may be getting hard to breathe with activity (mild difficulty breathing), or you may have to work very hard to breathe even when you’re at rest (severe difficulty breathing).

Pain in children 3 years and older

Severe pain (8 to 10): The pain
is so bad that the child can't stand it for more than a few hours, can't sleep,
and can't do anything else except focus on the pain. No one can tolerate severe
pain for more than a few hours.

Moderate pain (5 to 7): The pain is bad enough to disrupt the child's normal activities and
sleep, but the child can tolerate it for hours or days.

Mild pain (1 to 4): The child notices and may complain of the pain,
but it is not bad enough to disrupt his or her sleep or activities.

Pain in children under 3 years

It can be hard to tell how much pain a baby or toddler is in.

Severe pain (8 to 10): The
pain is so bad that the baby cannot sleep, cannot get comfortable, and cries
constantly no matter what you do. The baby may kick, make fists, or
grimace.

Moderate pain (5 to 7): The baby is
very fussy, clings to you a lot, and may have trouble sleeping but responds
when you try to comfort him or her.

Mild pain (1 to 4): The baby is a little fussy and clings to you a little but responds
when you try to comfort him or her.

Many things can affect how your body responds to a symptom and what kind
of care you may need. These include:

Your age. Babies and older
adults tend to get sicker quicker.

Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart
disease, you may need to pay closer attention to certain symptoms and seek care
sooner.

Medicines you take. Certain
medicines, herbal remedies, and supplements can cause symptoms or make them
worse.

Recent health events, such as surgery
or injury. These kinds of events can cause symptoms afterwards or make them
more serious.

Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug
use, sexual history, and travel.

Try Home Treatment

You have answered all the questions. Based on your answers, you may be
able to take care of this problem at home.

Try home treatment to relieve the
symptoms.

Call your doctor if symptoms get worse or you have any
concerns (for example, if symptoms are not getting better as you would expect).
You may need care sooner.

Pain, pressure, or a
strange feeling in the back, neck, jaw, or upper belly, or in one or both
shoulders or arms.

Lightheadedness or sudden
weakness.

A fast or irregular heartbeat.

The more of these symptoms you have, the more likely it is that
you're having a heart attack. Chest pain or pressure is the most common
symptom, but some people, especially women, may not notice it as much as other
symptoms. You may not have chest pain at all but instead have shortness of breath, nausea, numbness,
tingling, or a strange feeling in your chest or other areas.

Call 911 Now

Based on your answers, you need
emergency care.

Call911or other emergency services now.

Home Treatment

Home treatment may help relieve
pain, swelling, and stiffness related to a neck problem.

Apply ice or cold packs for 15 to 20 minutes,
3 or 4 times a day or up to once an hour for the first 24 to 48 hours. Cold
decreases swelling and pain. Keep a towel between your skin and the ice to
prevent
frostbite. Do not fall asleep with the ice on your
skin.

Try ice massage. Massage the painful area with ice for 2 to 7
minutes, long enough to numb the pain. Ice frozen in a foam cup works well. Be
careful not to damage your skin (frostbite).

Gently massage or rub the area to relieve pain and
encourage blood flow. Do not massage the injured area if it causes
pain.

After 48 to 72 hours, if swelling is gone, apply
heat. Use a warm pack or heating pad set on low. Some
experts recommend switching back and forth between heat and cold treatments.
You also can begin gentle exercise with the aid of moist heat to help restore
and maintain flexibility.

Continue with your usual daily
activities unless you have severe neck and back pain. Modify or avoid any
activity that makes your pain worse.

Practice good
posture. Avoid slouching or a head-forward
posture.

When sleeping, place a small support pillow under your
neck, not under your head.

When the pain begins to get better,
start doing
neck exercises. Do each exercise twice a day, 5 times
each, and gradually increase to 10 times each. Do not do any exercises that
cause pain.

Aspirin (also a nonsteroidal
anti-inflammatory drug), such as Bayer or Bufferin

Talk to your child's doctor before switching back and
forth between doses of acetaminophen and ibuprofen. When you switch between two
medicines, there is a chance your child will get too much medicine.

Safety tips

Be sure to follow these
safety tips when you use a nonprescription medicine:

Carefully read and follow all directions
on the medicine bottle and box.

Prevention

To help prevent neck pain caused by posture or body mechanics:

Avoid slouching or a head-forward posture. Sit straight in
your chair with your lower back supported, feet flat on the floor, and
shoulders relaxed. Don't sit for long periods without getting up or
changing positions. Take short breaks several times an hour to
stretch your neck muscles.

If you work at a computer, adjust the monitor so the top of
the screen is at eye level. Use a document holder that puts your work at the
same level as the screen. For more information, see the topic
Office Ergonomics.

If you use the telephone a lot, use a headset or
speaker phone. Don't cradle the phone on your shoulder.

Adjust the seat of your car to a more upright position that supports
your head and lower back. Make sure that you are not reaching for the steering
wheel while driving. Your arms should be in a slightly flexed, comfortable
position.

Make sure children and teenagers use school bags and backpacks correctly.

To help prevent neck pain caused by your sleep habits:

Use a pillow that keeps your neck straight. Special neck support pillows called cervical pillows or rolls may
relieve neck stress. You can also fold a towel lengthwise into a pad that is
4 in. (10 cm) wide, wrap it
around your neck, and pin it in position for good support.

Don't sleep on your stomach with your neck twisted or
bent.

If you read in bed, prop up the book so you aren't using
your arms to hold it up and bending your neck forward. Consider using a
wedge-shaped pillow to support your arms and keep your neck in a neutral
position.

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